Provider Demographics
NPI:1144043852
Name:URBINA MEDINA, JOEL EXEQUIEL (SA-C)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:EXEQUIEL
Last Name:URBINA MEDINA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 W 44TH PL APT 337
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3385
Mailing Address - Country:US
Mailing Address - Phone:806-853-0638
Mailing Address - Fax:
Practice Address - Street 1:1355 W 44TH PL APT 337
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3385
Practice Address - Country:US
Practice Address - Phone:806-853-0638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-02
Last Update Date:2024-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-497246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant